(^148) Medical-Surgical Nursing Demystified
PROGNOSIS
Prognosis may be guarded, depending on how severe the reaction is and how quickly
treatment is rendered. Patients need to be monitored for 1 to 2 days after treatment
and cautioned about reexposure to the offending item.
HALLMARK SIGNS AND SYMPTOMS
- Shortness of breath due to swelling of the larynx
- Hypotension and shock due to generalized vasodilation
- Sneezing—a common occurrence to an allergan
- Anxiety secondary to difficulty in breathing
- Rales (crackles) heard in the lungs—due to fluid in the lungs
- Wheezing (rhonchi) due to bronchospasm
INTERPRETING TEST RESULTS
Tryptase levels are from mast cells which increase in anaphylaxis. After the acute
episode is over, allergy skin testing is recommended.
TREATMENT
- Administer emergency medications:
- epinephrine to open airways and to reduce bronchospasm
- corticosteroids to reduce symptoms
- antihistamines to mitigate symptoms
- Administer circulatory volume expanders to treat hypotension caused by
vasodilation:- saline
- plasma
- IV fluids
- Administer vasopressors to counteract vasodilation and to increase blood
pressure:- norepinephrine
- dopamine